Systemic Arterial-to-Pulmonary Artery Shunt Utilization

Abstract

Background: Congenital heart disease (CHD) is a significant cause of childhood morbidity and mortality worldwide. Treatment often involves systemic arterial-to-pulmonary artery shunts (SAPAS); local data is sparse. Methods: A retrospective study was carried out at the Kenyatta National Hospital in Nairobi (Kenya) between January 1st 2006 and December the 31st 2012. All patients who received a SAPAS at the institution during the study period were included. Results: Twenty-four SAPAS were performed on 22 patients. Ten of 24 SAPAS’s (41.7%) were central shunts and 14 of 24 SAPAS’s (58.3%) were modified Blalock-Taussig shunts. The median age and median weight were 20 months (range 3-120) and 11.6 kilograms (range 4.7-23) respectively. The median pre-operative and post-operative arterial oxygen saturations were 68% (range:29-92) and 89% (range 52-100) respectively. Postoperative heparin was used in 4 of 23 shunt procedures (17.4%). The in-hospital operative mortality was 25%. Median length of post-operative follow-up was 1 year; 95% were lost to follow-up. Four out of 22 patients (18.2%) had a subsequent definitive palliative procedure. Conclusion: The utilization of SAPAS’s is not optimal; this may be related to the poor post-operative follow up of our patients. Further study is required to determine the reasons for poor follow-up.

Key words: Blalock Taussig, Shunt